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埃塞俄比亚西北部贡德尔大学专科医院就诊的五岁以下营养不良儿童的血液学异常及相关因素

Hematological Abnormalities and Associated Factors Among Undernourished Under-Five Children Attending University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

作者信息

Getawa Solomon, Getaneh Zegeye, Melku Mulugeta

机构信息

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

出版信息

J Blood Med. 2020 Dec 18;11:465-478. doi: 10.2147/JBM.S284572. eCollection 2020.

Abstract

INTRODUCTION

The hematopoietic system is one of the systems which can be affected by malnutrition, leading to impaired production of all blood cell lines. Undernourished children with hematological abnormalities like anemia are at higher risk of mortality. Therefore, this study aimed at determining the magnitude and associated factors of hematological abnormalities among undernourished under-five children attending at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

METHODS AND MATERIALS

An institution-based cross-sectional study was conducted on a total of 251 undernourished under-five children at University of Gondar Specialized Referral Hospital from January to May 2020. A convenient sampling technique was employed to select study participants. Data were collected using a pretested structured questionnaire. Blood samples were collected for complete blood count which were determined by Sysmex KX-21N analyzer. Stool sample was processed via direct wet mount. Thin and thick blood films were examined to assess malaria parasite. The data were entered to EpiData version 4.6.0.0 and analyzed using SPSS version 23 software. Bi-variable and multi-variable binary logistic regression model were fitted to identify factors associated with hematological abnormalities. A p-value <0.05 in the multivariable analysis was considered as statistically significant.

RESULTS

The overall magnitude of anemia, leukocytosis, thrombocytosis, thrombocytopenia, and leukopenia was 53.4%, 26.7%, 23.9%, 8%, and 2.8%, respectively. Being male, age 6-23 months, high birth order, intestinal parasite infection, edema, not eating vegetables and fruits, and paternal occupation were found to be associated with anemia. Only the age of a child was associated with leukocytosis in undernourished children.

CONCLUSION

The current study demonstrated the predominant existence of anemia, leukocytosis, and thrombocytosis among undernourished under-five children. Therefore, early diagnosis, monitoring and setting intervention strategies for anemia especially among children under two years old are required to prevent further complication.

摘要

引言

造血系统是易受营养不良影响的系统之一,会导致所有血细胞系的生成受损。患有贫血等血液学异常的营养不良儿童死亡风险更高。因此,本研究旨在确定埃塞俄比亚西北部贡德尔大学专科医院就诊的五岁以下营养不良儿童血液学异常的严重程度及相关因素。

方法和材料

2020年1月至5月,在贡德尔大学专科医院对总共251名五岁以下营养不良儿童进行了一项基于机构的横断面研究。采用便利抽样技术选择研究参与者。使用预先测试的结构化问卷收集数据。采集血样进行全血细胞计数,由Sysmex KX - 21N分析仪测定。粪便样本通过直接湿片法处理。检查厚薄血涂片以评估疟原虫。数据录入EpiData 4.6.0.0版本,并使用SPSS 23软件进行分析。采用双变量和多变量二元逻辑回归模型来确定与血液学异常相关的因素。多变量分析中p值<0.05被认为具有统计学意义。

结果

贫血、白细胞增多、血小板增多、血小板减少和白细胞减少的总体发生率分别为53.4%、26.7%、23.9%、8%和2.8%。男性、6 - 23个月龄、高出生顺序、肠道寄生虫感染、水肿、不吃蔬菜水果以及父亲职业被发现与贫血有关。在营养不良儿童中,只有儿童年龄与白细胞增多有关。

结论

本研究表明五岁以下营养不良儿童中贫血、白细胞增多和血小板增多情况普遍存在。因此,需要对贫血进行早期诊断、监测并制定干预策略,尤其是针对两岁以下儿童,以预防进一步并发症。

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